Audrey C Lively, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA07450 Issued in TX

Practice address

6414 Fannin St Ste G150
Houston, TX 77030-1514

Phone

(713) 486-7515

NPI assigned

Sep 15, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1316044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1396027306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 FANNIN ST STE 1700",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301526",
            "telephone_number": "713-486-6998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6414 FANNIN ST STE G150",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301514",
            "telephone_number": "713-486-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVELY",
        "first_name": "AUDREY",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-15",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA07450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Live Smart Pharmacy
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• Live to Give HCS Corp
• Live Well USA Corp
• Livelong Health Care Services, Inc
• Jennifer B Lively, OTR
• Liver & Digestive Consultants, Inc.
• Liver Associates of Texas, P.a.
• Liver Specialists of Texas PLLC
• Liver Specialists of Texas, PLLC

• Surgical Physician Assistant in Houston, TX
• Providers in Houston, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.